Communicating effectively with a person who has Alzheimer's

Alzheimer's gradually strips the meaning from words, causing frustration, anger and frayed nerves. Follow these tips for more successful give and take.

When you try to communicate with someone who has Alzheimer's, you may feel like you've dropped through the rabbit hole into Alice's wonderland. Because Alzheimer's disease slowly erodes communication skills, an affected person's words and behavior may make little or no sense to you.

Your loved one may have just as much trouble deciphering your words. The resulting misunderstandings can fray the tempers of everyone involved, making communication even more difficult. It's incredibly frustrating — for both of you.

The problem progresses

Alzheimer's damage to pathways in the brain may make it more difficult to recall and to understand words. The frustration of having a precise word "on the tip of your tongue" becomes increasingly common for people with Alzheimer's.

Sometimes, one word is incorrectly substituted for another. Or your loved one may just invent an entirely new word to describe a familiar object. He or she may get stuck in a groove, like a skipping record, and repeat the same word or question over and over.

People with Alzheimer's may also:

Lose their train of thought
Struggle to organize words logically
Need more time to understand what you're saying
Curse or use offensive language

What can you do to help?

Make allowances. Try to remember that your loved one is not acting this way on purpose. Don't take it personally. It's the disease talking, not your loved one.
Show interest. Maintain eye contact and stay near your loved one so that he or she will know you're listening and trying to understand.
Avoid distractions and noise. Communication is difficult, if not impossible, against a background of competing sights and sounds.
Keep things simple. Use short sentences and plain words. Avoid complicated questions or directions. When communicating a task or request, break it down into single steps. Following a multistep command will be a setup for failure in someone with Alzheimer's disease.
Don't interrupt. It may take several minutes for your loved one to respond. Avoid criticizing, hurrying, correcting and arguing.
Use props and visual cues to increase recognition. For example, take the person to where the toilet is visible, and point to it before asking if he or she needs to go to the bathroom.
Don't argue. In this disease, reasoning and judgment capabilities decline over time. Avoid trying to convince them that they are wrong and you are right, in which case the most likely outcome will be increased anger and agitation.

Remain calm and relaxed

Even if you get frustrated, try to keep your voice calm and relaxed. If your words and the way you say them don't match, it may be confusing. Your nonverbal cues, including the tone of your voice, often send a clearer message than what you actually say.